Life-style changes associated with acculturation and modernization have resulted in an increase in weight among Navajo people that is associated with an increased risk for diabetes and cardiovascular disease. Interviews with Navajo families of varied socio-economic backgrounds will investigate the kinds of nutritional knowledge possessed by the various members of the family. Different eating "scenes" will be identified, and the characteristic foods and social interactions associated with them described. Decision models of the choices of foods for meals will be developed from interview data. A more general survey of a larger group will be conducted in order to establish the representativeness of the nutritional beliefs and behaviors found in the interview data for the Navajo population as a whole. Specific sub-groups of families with members affected by diabetes or at special risk for the development of diabetes will be studied to ascertain if there are any distinctive patterns that characterize them. Those families with members suffering from diabetes will be the subject of a special attempt to detect an association between nutritional knowledge and lower blood glucose levels as monitored by the PHS Hospital in their regular outpatient visits. A group of the families which include mothers who had gestational diabetes during one or more pregnancies will be studied to determine whether the families' nutritional patterns or genetic factors are responsible for the increased risk of diabetes associated with the children of such mothers. The information gathered in the research will be used to help IHS personnel design effective risk-factor reduction interventions. Such life-style changes in diet and activity will be most effective if based upon culturally appropriate patterns which this research is designed to discover. Students will gain skill in sampling methodology, abstracting from medical records, construction of questionnaires, interviewing skills, elicitation and display of kinship information, epidemiology and statistics, and construction and evaluation of medical and behavioral interventions. Students will learn about the complications of diseases with genetic components, environmental factors and interactions between behavioral and medical aspects of health.